臨床病理討論會(huì)ppt課件(編輯修改稿)
2025-02-01 04:24 本頁面
【文章內(nèi)容簡(jiǎn)介】 CKMB 196 368 687 403 207 101 Cre Bil Lab Data D A T E9 / 2 29 / 2 09 / 1 89 / 1 69 / 1 49 / 1 2Troponin I (ng/ml) 120100806040200D A T E9 / 2 29 / 2 09 / 1 89 / 1 69 / 1 49 / 1 2U/L8006004002000G O TC KM BLab Data Serology study。 ? Mycoplasma pneumonia IgM: (9/12) positive, (9/21) negative ? Other virology study: all negative Coxsackie A, Coxsackie B1B6, CMV IgG amp。 IgM, Enterovirus 70, Influenza A amp。 B Lab Data Culture: ? Throat swab (9/12): Staphylococcus aureus ? Nasal swab (9/12): Staphylococcus aureus, Viridans streptococci ? Blood (9/19): Staphylococcus epidermidis Discussion Diagnostic approach: Cause of chest pain in children ? Idiopathic: 1245% ? Costochondritis: 922% ? Musculoskeletal trauma: 21% ? Cough, asthma, pneumonia: 1521% ? Psychogenic factors: 59% ? GI disorders: 47% ? Cardiac disorders: 04% Diagnostic approach Hx: cough, vomiting PE: hypotension jugular venous distention tachycardia irregular heart beat basal r228。les poor peripheral perfusion Cardiovascular promise Diagnostic approach Flulike illness, arrhythmia, cardiovascular promise Acute myocarditis highly suspected D/D: Dilated cardiomyopathy Anomalous left coronary artery Chronic tachyarrhythmia Pericarditis Diagnostic approach EKG: ? VPC bigeminy, ventricular tachycardia ? STsegment change Elevated cardiac enzyme Echocardiogram: marked LV dyskinesia Endomyocardial biopsy ? Lymphocyte infiltration ? Myocyte degeneration Acute myocarditis confirmed Clinical classification of myocarditis Fulminant Acute Chronic active Chronic persistent Initial presentation Shock, severe LV dysfuntion CHF CHF Normal LV function Endomyocardial biopsy Multifocal active myocarditis Active or borderline myocarditis Active or borderline myocarditis Active or borderline myocarditis Nature history Complete recovery or death Inplete recovery or DCM DCM Normal LV function Myocarditis: an enigmatic disease! Dark side of the myocarditis Initial nonspecific s
教學(xué)課件相關(guān)推薦
鄂ICP備17016276號(hào)-1